Episode 42
The Label of “Addiction”

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Description

Is the word “addiction” helpful or limiting? We discuss if repositioning our verbiage can aid in shifting the stigma and true understanding of why individuals struggle with dependence and mental health disorders.

Talking Points

1. What does it mean when we mention we want to ‘disrupt’ our industry?
   
2. What are the benefits and downfalls of using the word ‘addiction’ within the treatment industry?
   
3. How is this word disruptive?
   
4. The benefits we can see from making the shift in verbiage
   

Quotes

“Even though ‘addiction’ describes a behavior, it describes a stigmatized behavior. It describes a behavior that we continue to separate out as different from different behaviors when in reality it’s just another maladaptive behavior. Even more so what it does continues to fracture the industry and continues to separate out that the behavior of addiction, or the behavior of substance use, is somehow different and should be treated differently than those who struggle with mental health disorders. That is when I see it becoming the most detrimental to our industry.”

Clinton Nicholson, MA, LPC, LAC

Episode Transcripts

Episode 42 Transcripts

[Music]
hello everyone
welcome back to finding peaks brandon
burns chief executive officer excited to
be with you all again i always love the
opportunity to come and host
because i am your favorite host at
finding peeks i know that top three
at least within the top three but
more in particular the top one yeah
me
joined by chief operating officer clint
nicholson everyone
also trained certified excellent
therapist we don’t talk about that a lot
because his title is in the way
chief clinical officer
jason friesman everybody does all the
clinical things does them with
panache
yeah and extraordinary
stuff stuff
all right yeah we’re getting rid of
words
we’re trying to be a little bit more fun
here at finding peaks myself included
from the host position i do some q a and
sometimes that comes off as a little dry
according to our viewers so i’m just
trying to pep it up a little bit to
interact with you all better and i’m
listening so keep those comments coming
finding peaks at peaksrecovery.com
we hear you and we love you
what we’re talking about today here at
peaks for
finding peaks excuse me
is this word addiction
and um one step back before we dive into
what we want to talk about here is that
the vision of peaks recovery has been to
disrupt an industry through quality of
care so what does it mean to disrupt an
industry
and
the things that we want to disrupt today
is to talk about the word addiction and
whether or not it’s a limiting
word
that we use within our industry that’s
limiting opportunities as far as getting
well
for me in particular as an example i
think about when somebody says i’m an
addict for example or i have an
addiction that it’s some sort of
character trait for which they cannot
get away from uh i know we’ll talk a
little bit more about it it was the
thing that i wanted to kind of insert
that within the dsm-5 addiction is not a
word it’s not a framework we don’t call
insurance companies and say hey we got
an addict in care please give us dates
of service we’re talking about things
like dependence or using other language
like substance use disorder and so
out of that to kick this off with the
first question to antagonize the
potential disruption of this language
how does the word addiction first and
foremost benefit us as an industry
before we move into maybe how it doesn’t
benefit us or where we see those
limiting features
and so we’re going to do a little little
pro and cons here uh across the board
and so maybe i think we start with the
pros how does the word addiction benefit
us as an industry i mean i think
you know addiction just in its name
means basically an inability to stop
some sort of compulsive or unwanted
behavior
and um
and i think it benefits us because it is
kind of universally understood what
uh addiction is certainly there are
nuances and that sort of thing um
uh related to addiction but i don’t know
that’s my first thought to your question
what do you think pecans what’s
how does addiction benefit us
um yeah i guess i agree with jason in
the sense that it’s kind of a common
language right it’s it’s part of when we
talk about addiction it’s generally
understood what we’re talking about that
there is this sort of attachment to
something or inability to stop something
that
um typically is skewed towards the
negative that it’s actually causing a
significant disruption in somebody’s
life or it’s an unwanted attachment to
something or an unwanted inability to
stop something
so in that sense i think it does
uh there’s some commonality and some um
i don’t know familiarity
him with that word at the same time i
can i go into the no
no he’s the host no okay
so
okay
lead in you know you’re gonna steal the
questions
so okay so a little bit of backdrop here
and this is going to be wildly
disruptive maybe for those who are
really anchored in the concepts of
addiction that i’m an addict i will
always be an addict and if i don’t have
this language then it moves me into a
position of you know maybe
uh or opens the door to where you know
negotiating
potentially having another drink again
is okay so i was listening to this smart
guy at a conference i believe it was the
national association of addiction
treatment providers conference and the
opening guy
uh gentleman with a british accent super
brilliant works for our harvard
university he’s a professor there and he
said
daringly in front of all these
clinicians and doctors and so forth
after five years of not using drugs or
alcohol you were at no greater risk than
the general public
of forming an addiction by having that
next drink moving forward
and to be absolutely clear this was not
a guy up there stating and the meth and
the heroin and all that thing i think
he’s negotiating responsibility and
sustainability within his talk to be
totally charitable to the situation
which he’s describing but he’s talking
about things like neuroplasticity
of course that informs that we form new
neural pathways and so in those ways
addiction as a framework has been sort
of disrupted within that time period so
um
with that that’s language that’s sort of
antagonizing this notion of addiction
once an addict always an addict so
how is this word now to be the con to
bring the con into this
actually disruptive or limiting uh in
this way because per what um
people more intelligent than me are
talking about at these conferences are
stating is that an addict today isn’t
always going to be an addict in the
future or have the potential in that
regard so um how is this word right now
as it stands sort of disruptive and how
do we see that disruption within you
know maybe peaks or just in the general
world or when we’re talking to the
patient demographic in front of us
well i think specifically within the
substance
use world addiction has a sense like
you’ve been alluding to of permanency
like it’s something that is just always
there and it becomes a part of your
character it becomes a part of who you
are and it’s something that and this can
go i guess both ways it’s something that
people start to identify with and
identify as as an addict and
in that sense um it’s sort of like a
scarlet letter but it’s a tattoo it’s
not something that you can rip off your
clothes it’s something that you forever
wear on your skin and
that starts to bring in the more
shame-based narratives about addiction
within our culture or within substance
use and substance dependence in our
culture which is that it’s some a moral
deficiency right that there is something
um
there is a lack or
an inability to control oneself
that is based in weakness which is why
you are this thing that we call an
addict so um
that’s the first part of my answer there
are multiple parts but i want to give
well and in a way too right the
anonymous culture the thing we’re trying
to bring to light the 22 million 25
million people in recovery those sort of
features
remained in anonymity because or maybe
as a result of that negative connotation
that was experienced by that we couldn’t
talk about it openly because of this
character trait or flaw or however it
was perceived this is something it
becomes something that i am rather than
something that i’m struggling with right
and
it because of that i think that we um
using the word perpetuates those sorts
of belief systems and stereotypes and
that need for anonymity yeah
i saw you both look at me so i’ll go
ahead and speak that’s your cue thank
you
um i do think
a couple things came to mind as you guys
were talking first being
um that
i’ve been doing this long enough now to
watch the word alcoholic kind of go from
a common phrase used and now we don’t
use it uh in a clinical sense at all do
we say the word alcoholic or alcoholism
because of that connotation i believe
frankly and um
and really because it also set apart
other
addictions or other substance use
disorders apart from alcohol use
disorder if you will and so
um we’ve already we we have some
precedent in our industry of like moving
away from vernacular that begins to not
make sense
um or has kind of a pejorative
connotation to it
um the other thing that i do think
though that’s interesting from the super
smart dr harvard british guy uh is that
even in aaa there was this sense uh
there’s a portion of the book that talks
about alcohol reaching a point of
neutrality which i think is interesting
that’s before kind of the neuroscience
of it all but even
even in that um
uh
older literature there is they do talk
about reaching a point where where you
like alcohol doesn’t trigger you one way
or cravings don’t occur one way or
another it reaches neutrality
people don’t focus on that part a lot
truthfully and and um i’m certainly not
here to
uh defend all of that taking on the
cloak of i am an addict i’m an alcoholic
i don’t find those to be helpful at all
but i think it’s an important uh piece
to recognize that even
in some of that way older literature in
the first literature actually they
acknowledge some of that plasticity even
though they wouldn’t call it that
by any stretch of the imagination so
that that’s my initial thought on it and
i do think
to me there is a distinction between the
word addict and addiction
one describes a person one the other
describes behavior
and i’m i mean i’m easily in the camp of
like let’s get rid of the word addict
like i i don’t love that i don’t love
that terminology i don’t find that to be
useful at all um
uh in any way i i you know addiction i
think is a little bit more challenging
to un
unravel from our field
yeah
i mean i can i
agree to a point i think i
uh i think we’re done thank you
it’s a very small point though right so
it’s like pinpoint okay yeah i agree to
a pinpoint on that okay uh i think it’s
going to be it’s hard to get rid of that
word and i think a couple of months ago
i remember going up to you jason and
saying hey you know
in the future what i want to do is have
a program where we get rid of the word
addiction and there was a little bit of
a moment of like what the heck are you
talking about excuse my language i
apologize what the heck are you talking
about
it’s a book it’s a book you read
there was a wtf moment yeah and um
but i think what i started to recognize
over the years was
even though
addiction describes a behavior it
describes a stigmatized behavior right
and it describes a behavior that we
continue to separate out as different
from other behaviors like it’s when in
reality it’s just another maladaptive
behavior of which there are an infinite
you know plethora that people can choose
from on any given day and and
even more so what it does is it
continues to fracture the industry and
it continues to separate out that
that addiction the behavior of addiction
or the behavior of substance abuse and
dependence is somehow different and
should be treated different from people
who are struggling with mental health
disorders when in reality they’re all in
my mind one in the same
so in that sense i think
that’s when i see it becoming the most
not disruptive to the industry but the
most
detrimental to the industry
when i think
i think you bring up an interesting
point too is that i think
um
as a field we’ve taken the word
addiction
and then
actually try to keep expanding addiction
into process addiction and gambling
addiction and
sex and love and pornography and and
food and and all of that like we’ve
actually
been working in the other direction
actually trying to make everything an
addiction right right
but really cheapening
the word i guess or or late or
i don’t know making a stereotype out of
the out of the word
and there’s a process missing the point
of what we’re actually trying to address
which is we have a behavior that is
that is causing a major amount of
disruptions in someone’s life to the
point of where it’s become detrimental i
mean that’s that’s really
that’s what we’re looking at we’re
looking at a behavior it’s we’re not
looking at an addiction you know it’s a
and we can look at any behavior we can
look at any pattern of thought or mental
processes and say the exact same thing
but yeah we we start to label things oh
i’m yeah i’m addicted to tick-tock i’m
addicted to blah blah blah you know and
it does it it’s
it’s
it takes away what actually that word i
think initially meant which was to
highlight that this is something that
people struggle with and it’s an illness
but what really is i think as we’ve
progressed of our understanding of the
brain and sort of
neuropsychiatry
that we recognize what we have is a
physiological dependence you know that’s
really at the crux of a sort of what we
would call addiction is this
physiological dependence that
begins to transform into a psychological
sort of obsession as well
and then you get the the psychosocial
factors or the the sociological factors
on the outside and you have this really
complex biopsychosocial
disorder that you’re dealing with
and
but again we lose all of that nuance
when we just say oh you’re an addict or
i have an addiction like we’ve
we’ve because it’s become so cheap
we’ve lost what is really a very um
what is really a very expensive
disorder that people deal with and it’s
emotionally expensive psychologically
expensive
and sociologically expensive as well and
and adding to it as well
as as far as the way that i i also see
the language being disruptive is we have
these concepts of addict and normie
so i’ll walk into a situation at you
know peaks and say well you know i just
have this experience behaviorally that i
walk into a restaurant and i have two
drinks and then i sort of negotiate in
that moment third drink or you know to
water or nothing and go home or you know
take a cab or whatever the case might be
and somebody’s like well that’s exactly
how a normie would think
and well it’s a behavior that i’m
experiencing in that moment now in a
setting maybe night out with the boys
we’ll call it to you slapstick language
here right uh maybe i’m celebrating you
know at at one of my buddy’s house or
an event where we’re doing a bachelor’s
party or something like that
in those situations
with the normie disposition i might
behave and have three or four drinks in
that regard and so
but in that the behaviors are changing
per the setting where
addiction of course is those behaviors
are consistent through all settings and
continuing to move forward but
um ultimately it it feels like
again we’re talking about the behaviors
of the situation and i guess the thing
that i want to say that is frustrating
about this is it feels like when i have
this notion that i’m an addict
i’m walking away from a treatment center
and instead of maybe
exploring the relapse out of this subset
that it’s this 0 to 60 back to all
across the board you know drinking using
abusing drugs and alcohol whatever it
looks like
in that regard because
through the language the individual
doesn’t have the experience that i have
any other choice than to actually
do a different behavior or to
participate in this in another way
in that regard of course i’m not
advocating for walking out of treatment
and doing these things but it seems
again to be more of a behavioral issue
than
this thing that i am at the end of the
day because a normie doesn’t define in
any sense of the term how many drinks i
have in any given setting or whatever
the case is
i’m also perfectly okay with getting rid
of the word normie yeah
right well i think you know to your to
your point and i’ll actually play a
little bit of devil’s advocate to you uh
brandon i think that we have to be
careful that by getting rid of the word
addiction we don’t in any way disparage
or disregard the suffering that goes
along with was struggling with addiction
because it isn’t it’s it’s really easy
to say it’s a behavior but it’s a
behavior that’s motivated by something
much more complex as well right because
you have this neurological dependence
that takes
years to navigate and to really recover
and heal from plus of all the other
external or physiological factors that
might come into play
you know
there is value though in describing like
describing some people
in our old vernacular of addiction
addiction
again using the old vernacular does tend
to be progressive whereas
you know you you’re just your
description of celebrating at a wedding
and having a few drinks or whatever
maybe more than you normally would
it isn’t on this progression and and i
do think
people
that i’ve watched with substance use hit
some sort of threshold and then it
becomes progressive until
they get the help they need to treat the
things that are underlying the the
behavior so i
i don’t know i i think
right i don’t want to lose track of some
of this because i do think there is
there is some importance here there are
some nuance issues that do need to be
but it i think at that moment jason is
where it’s actually it’s beneficial to
lean into the that it is at that point
neurology it is chemistry it is your
body that is making something
progressive it’s not your it’s not your
attachment to the behavior it is
literally your body telling you to not
stop like you don’t as we don’t increase
our behaviors
um
we’re not going to increase those
behaviors
because we want to right like it’s not
out of okay i i come i 100 agree with
what you’re saying i’m just saying it’s
it’s helpful to make sure we have that
word for says
whatever that word may be or a way to
describe that hey
there’s a point that you’ll reach where
the neurobiology takes over and like
you’re gonna you can’t stop by yourself
and so at that point i think we have
progressive dependence right so i think
that there are and again
it’s you know and this is the english
nerd in me like
words have power like they absolutely
have power and the things that we say
and the way that we say them the way
that we talk about them
absolutely impacts not only the way that
people internalize and
identify
with themselves but also the way in
which they’re treated in social settings
and in treatment settings and i think
that if by changing the language and
really focusing more on the on what’s
really happening in inside the body and
then the impact that that has on the
behaviors we start to make it less about
this person has something wrong with
them you know it’s not about
this person is is an addict therefore or
you have an addiction and so you’re
different than me right right
and as well too i mean just to
bring back the normy language a little
bit here that i’m equally susceptible to
the notion of an addiction or to
dependence in this regard because a life
event or whatever could occur or
being at the bachelor’s party now i’m
having excess drinks or whatever and
maybe some amphetamines fall fall into
the room or whatever and i find myself
doing it because i think i’m a normie
and then the behaviors and everything
progresses from there and it’s something
so intoxicating that i end up you know
getting involved with at that level so
like there’s also nothing about normie
dispositions that are limiting to the
degree that i won’t form a dependence
around something or obtain an addiction
at least in the way that we’re talking
about it
um
so yeah i just wanna and to speak the to
the us and them language too like i’ve
been asked
hundreds of times if i’m an addict
working in this field
by clients because
and and frankly
you know i’m just like whether or not i
am or not like it it literally doesn’t
matter like i’m a human that has had
human problems and like you’re human
with human problems too and like let’s
move forward
um
because it isn’t that us and them thing
like it it exists
i don’t even want to use the word
normally but like it it exists in the
way that you’re describing but it also
exists in the counterweight too where
it’s absolutely you’re not on our team
right you don’t how could you understand
yes right and it’s really a matter of no
i’m a human being and i suffer and and
sometimes when i suffer i do
the the way in which i respond to that
is actually really maladaptive to my
life and really detrimental to my life
and actually reinforces the suffering
rather than
mitigates the suffering so
we all go through that process in that
cycle constantly because we’re human
beings but by saying that well well the
cycle the behavioral cycle of an addict
is or addiction is somehow different
than somebody who’s suffering from let’s
say depression or bipolar or even
something is uh like schizophrenia um
again we we create these these huge
separations and chasms between
individuals in between what are really
relatively
uh congruent mental health disorders you
know congruent in the sense that they
they’re not as different as we may think
they are you know they respond
it’s all about suffering and response in
the end right so and we can all do
better at responding better to suffering
we can all
learn how to do a better job of that and
the reality is that
we’re not all as a culture i don’t know
that we actually really prepare people
or train them or teach them how to do
well in those situations yeah
if anybody’s book hungry out there and
just really curious about this uh
existential and analytic philosophy uh
will inform all of the like he’s
clinton’s speaking of my my love
language here because it’s all informed
through that philosophy and i think it’s
brilliant and i think it’s worth diving
into and it’s worth discussion it feels
tedious to have this sort of play on
words but words do matter they do inform
a lot and we experience things uh by
associating ourselves with the language
in that regard so i think we’ve uh
captured uh sort of the benefits of
maybe removing or thinking about what
would it would look like to remove that
word from the industry so just curious
you know how is dependence versus
addiction language get us closer to our
goals within a treatment setting maybe
to kind of tie it up as a a final
question here what i i think
substance dependence doesn’t have
the stigma attached to it yet
yeah
until we remove that language and then
you form this language and then it
carries right
um i think that it’s
in removing that word it also removes a
lot of the limitations
and sort of um
about our understanding of addiction we
actually really don’t understand a whole
lot about addiction we really don’t
understand a whole lot about mental
health and about uh depression and about
schizophrenia and about
bipolar disorder i mean we are so we are
still in our infancy and really
understanding what’s going on in the
brain and the way in which that impacts
our behavior that by getting taking
these old words and ideas away it frees
up the space for us to to continue to
explore and deepen our understanding of
what we’re actually experiencing and how
to best treat and meet those needs um
it
it’s and again like you guys said there
will be a point where substance
dependence we’re like oh my god i can’t
believe we were ever using that that
almost feels derogatory to a certain
degree and so we’ll get rid of that
language because we’ll have a better
understanding of what’s actually
happening and a better way to speak to
it that is more honest and less limiting
when really we’re already going away
from the word dependence we’re at
substance use disorder
in the dsm now but yeah absolutely it’ll
shift i don’t it will and i think again
this isn’t too
you know i i think for mice for me
personally this isn’t to take anything
away from people
um
who identify as addicts or who recognize
addiction and feel like that’s a valid
way to to talk about what they’re
struggling with i think that language
has been used and is familiar and is for
a lot of people very adequate and it
actually feels right to them so by all
means i think that there is a place for
um that experience and for that um and
for that individual i think it really
what it when it’s becomes the most
um
problematic to me is within the setting
of treatment is when it because i really
do think that it becomes disrupted it
disrupts the industry in the wrong way
it just disrupts the industry towards
staying the same
and towards remaining uh in the in the
realm of stigma rather than disrupting
the industry forward
yeah
final thoughts jason
i think we laid it all on the table here
okay
we actually agree on a lot clinton yeah
absolutely i thought we were going to
disagree a little bit more
about where
we haven’t he did call me jason once
during this like in really yeah it was a
very like weighted yeah yeah
absolutely yeah
i think that there is again like this is
a this is hard stuff this is the part
but this is the part for me personally
but i really
is important because this is the future
right we can’t
uh we can get really good at doing the
same thing um but
i guess for me as an individual i’m not
here to do the same thing yeah and i
don’t think that you are and i
absolutely know that you are and that
peaks that’s what it means to disrupt
yeah
well in
all of that beautifully stated uh
especially by youtube maybe not by
myself but it takes me back to you know
the the vista research things that i’ve
in and conquer addiction episodes that
i’ve done with joanna conte
uh
in the past take a look at them and all
those if industry outcomes have remained
flat for the past 30 years at 33 or
below in that regards
i
and we are collectively i think
continuously curious about how to
disrupt those outcomes absolutely and
for the viewers on the other side of
here and i think you you said it you
know poetically in that regard we’re not
trying to dismount what has worked for
you or take away from anything that is
nurturing around this language but just
to have a discussion about
if we’re going to go from 33 percent out
comes to 50 outcomes we have to explore
things that are limiting features of our
industry and language the word addiction
might be one of those things and that is
simply what we are trying to explore
today so i appreciate everybody for
walking through this with us talking
about something that’s difficult
finding peaks at peaksrecovery.com send
us your feedback thoughts ideas uh
inform future episodes how we should
behave in these episodes uh find us on
the facebooks the instagrams but more
importantly the tick tocks chris burns
president founder doing an awesome job
at
screaming in the microphone and getting
people amped up on recovery and would
encourage all of you to follow his
journey uh on tick-tock it’s very
exciting as he explores mountaintops and
so forth so
all that stated uh brandon burns signing
off here at finding peaks and we’ll see
you next time